Following is an urgent question by the Hon Chan Han-pan under Rule 24(4) of the Rules of Procedure and a reply by the Secretary for Food and Health, Dr Ko Wing-man, in the Legislative Council today (June 3):

Question:

A man, who had come into contact with a confirmed patient of Middle East Respiratory Syndrome (MERS) in South Korea, arrived in Hong Kong by flight from South Korea on the 26th of last month. It has been reported that the man was questioned, as he had a fever, by a health officer about his conditions at the boundary control point at the airport, but he concealed his history of contact with a confirmed MERS patient and was finally allowed entry into Hong Kong. Subsequently, this man went from the airport to Huizhou in Guangdong Province via Sha Tau Kok by taking two cross-boundary coaches, and he was confirmed later to be a MERS patient. Since the man travelled together with quite a number of people on public transport during his stay in Hong Kong, quite a number of members of the public are concerned that MERS may spread in Hong Kong. In this connection, will the Government inform this Council:

(1) of the urgent and effective means adopted by the authorities for tracking the passengers who had come into close contact with the man when they travelled on the aforesaid two cross-boundary coaches, so as to take follow-up actions immediately;

(2) of the contingency measures adopted by the authorities to handle the situation where persons entering the territory conceal from quarantine officers information relating to an epidemic; whether the authorities currently have the statutory power to compulsorily place a person at the boundary control points under isolation and compulsorily arrange the person concerned to receive further examination when the authorities have reason to believe that the person concerned is infected with MERS; and

(3) given that the number of new MERS cases in South Korea has continued to rise in recent days, whether the authorities have grasped the latest situation of the MERS epidemic in South Korea, so as to take corresponding and urgent measures immediately; whether the authorities will, in response to the prevailing situation, immediately raise the alert response level and issue health advices and warnings to those Hong Kong people who intend to travel to South Korea for sight-seeing?

Reply:

President,

The Middle East Respiratory Syndrome (MERS) is a viral infection caused by a novel coronavirus (i.e. Middle East Respiratory Syndrome Coronavirus (MERS-CoV)) which has not been identified in humans before. The virus is different from any coronaviruses (including SARS-coronavirus) already found in humans or animals. Infected persons may present with acute serious respiratory illness and symptoms including fever, cough, shortness of breath and breathing difficulties. Most patients also develop pneumonia. It is still uncertain how MERS-CoV is transmitted. Based on the available information, people may be infected with MERS upon exposure to animals (such as camel), environment or other confirmed patients (such as in a hospital setting).

Since September 2012, MERS has been made a statutorily notifiable disease in Hong Kong under the Prevention and Control of Disease Ordinance (Cap. 599). The Centre for Health Protection (CHP) under the Department of Health (DH) is to be notified of any suspected or confirmed cases for investigation and follow-up actions. To enhance the effectiveness of response to possible risks of MERS, the Government announced the Preparedness Plan for MERS on June 12, 2014, which sets out in detail the Government's preparedness and response measures for the disease. The Alert Response Level under the Preparedness Plan for MERS was activated on the same day, having regard to the information released by the World Health Organization (WHO) and various factors.

Against the above background, my reply to the three parts of the question is as follows:

(1) It came to the notice of the CHP of a 44-year-old man (the target patient of Hong Kong), who was a close contact of the third MERS case in Korea (a 76-year-old man), arrived in Hong Kong from Korea and transited to the Mainland on May 26, 2015. The CHP immediately liaised with WHO and the health authorities of the Mainland and Korea to obtain the latest updates.

Epidemiological investigations revealed that the target patient was a passenger of OZ723 of Asiana Airlines and arrived at the Hong Kong International Airport at around 1pm. He then set off for Huizhou via Sha Tau Kok by taking two buses operated by Eternal East Cross-Border Coach Mgt. Ltd. in the afternoon of the same day.

Even before the target patient was confirmed by the Mainland authorities as infected with MERS, the CHP had already taken precaution measures. Together with other parties (including the Immigration Department, the airline company and Eternal East Cross-Border Coach Mgt. Ltd.), the CHP traced the contacts of the target patient, including those on the same flight and bus. The results show that among the 158 passengers on board OZ723 of Asiana Airlines on May 26, 2015, 81 were in the same cabin with the target patient, and 29 of them were within two rows of him and are thus classified as close contacts. As for the buses, the CHP immediately contacted Eternal East Cross-Border Coach Mgt. Ltd. to trace the staff members who had contacted the target patient (including the drivers who drove the above buses). As no passenger list was kept for the buses, the CHP released the bus information to the public as soon as possible and appealed repeatedly to persons who had contact with the target patient to get in touch with the CHP for follow-up.

As at June 3, 2015, all the 29 close contacts on board the flight were identified. Nineteen of them were asymptomatic and had been sent to the Lady MacLehose Holiday Village for isolation and surveillance. The remaining 10 close contacts were not in Hong Kong and their information had been delivered to the Immigration Department. Another 32 persons were confirmed as other contacts (including a member of ticketing staff of Eternal East Cross-Border Coach Mgt. Ltd., the driver of the buses and a bus passenger) and are under medical surveillance. Contact tracing is ongoing and the CHP has also set up a hotline to encourage relevant persons to contact the authorities as soon as possible.

(2) The DH has been conducting body temperature checks of all inbound travellers at boundary control points, and those with fever will be examined. There is an established set of criteria for compulsory referral in respect of MERS, which consists of clinical criteria and epidemiological criteria. The clinical criteria include body temperature at or above 38 degrees Celsius and symptoms of respiratory tract infection. The epidemiological criteria include having travelled to or resided in a country or region affected by MERS before onset of illness, or having close contact with patients infected with MERS. If an inbound traveller fulfills both the clinical and epidemiological criteria, the Port Health Office will compulsorily refer the traveller to a hospital under the Hospital Authority (HA) for further examination in an isolation ward.

At present, port health officers are empowered by the laws of Hong Kong to require a person suspected to be infected with specified infectious diseases (including MERS) for further examination. In accordance with the Prevention and Control of Disease Regulation (Cap 599A), if a health officer has reason to suspect that a person is a contact or is infected with a specified infectious disease or is contaminated, the health officer may subject the person to medical surveillance or a medical examination or a test. To achieve effective health screening at the border, we need full co-operation of the public and travellers in providing correct and comprehensive information for assessment and follow-up by health officers. If a traveller intentionally provides false information to health officers, the DH will consider taking enforcement action having regard to the advice of the Department of Justice.

In view of the latest outbreak situation in Korea and the fact that we have yet to obtain from the Korean authorities information on the healthcare facilities affected by MERS, the DH has enhanced surveillance measures in this regard. Inbound visitors who have recently visited healthcare facilities in Seoul, Korea and have fever and respiratory symptoms will be classified as suspected MERS cases. All visitors with fever will be referred to the port health officers for diagnosis. They will also be required to sign the health assessment form and reminded of the legal liability for providing false information.

(3) Upon activation of the Alert Response Level under the Preparedness Plan for MERS, a simplified response command structure has been put in place. The Food and Health Bureau will co-ordinate and steer Government response while the DH and the HA are mainly responsible for assessing the nature and level of risks. After activating the Preparedness Plan for MERS, the Government conducts risk assessment from time to time to determine whether adjustment to any measures is required. According to the health authorities of Korea, all MERS cases in Korea (including the exported case of the target patient) have been epidemiologically linked to the first MERS case there. There is currently no evidence of sustained human-to-human transmission taking place in the community of Korea. Having regard to the risk assessment, we consider that it is not necessary to raise the response level at this stage. Nevertheless, we convened an inter-departmental meeting in the morning of June 3, 2015 to update relevant departments on the latest situation of MERS so that they could take preventive measures accordingly. In addition, Hong Kong residents travelling to Seoul, Korea are repeatedly reminded to avoid unnecessary visit to the healthcare facilities there. Hong Kong's healthcare facilities and personnel are advised to suspend all exchange or visit activities with healthcare facilities and personnel in Seoul, Korea. We will continue to closely monitor the latest developments overseas and maintain liaison with WHO as well as the Mainland and neighbouring health authorities. The local response and health surveillance will also be adjusted if necessary.